Oncology (General Cancer)/unexplained high CRP

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Question
Hi Dr Higby,
I am a 58 yr old female -very active, all normal blood work and lipids, and don't drink, smoke or do drugs. However, for the last 18 mo my CRP which has always been less than 1 , has gone from 3 to over 6. My PCP is very puzzled; my cardio( I had an AF ablation last Sept, and no AF since)says"most people don't order that test!", and isn't the slightest concerned, even tho' my Dad died at 58 of a sudden heart attack and stroke.My Mum also had breast cancer at 56 and died at 58, but the rest of her live was fit and healthy!
We have a strong family history of cancer, and I'm really worried that I have some occult cancer lurking somewhere.
The elevation seemed to come from nowhere, and was there before the AF. I had an ANA , SR and rheumatoid factor, as I have some arthritis and they were negative. However I have had the arthritis for over 5 yrs when the CRP was really low.  
I do take HRT ( bioidentical), as I was having horrible hot flashes day and night, and that's the only link I have come across, but the increase that may be attributed to that seems only minimal, nothing as high as 4 or 6.
What else can I do to try and discover the cause of this? I also eat an anti-inflammatory diet, take fish oil, vit D , and am only 140llbs/5.6in. I have no apparent symptoms-it's scary as it's been high for so long. Can some folk simply produce more CRP as they age, without it being directly linked to chronic inflammation?
Any guidance would be so much appreciated I feel like a walking time bomb!
Thank-you so much for your time!

Answer
I suspect you have some kind of chronic inflammation going on.  If you have arthritis, it could be getting worse; it probably isn't cancer if it's been going on for a while.  If you are menopausal, that can temporarily raise the CRP, especially if you have severe hot flashes.  Even if you are taking HRT, the underlying process is not removed, just suppressed.  If you were my patient, I would probably not continue ordering CRP, since the test doesn't diagnose anything.  It just suggests that somewhere in your body cells are being stressed.  CRP doesn't predict heart attacks, but will rise after one happens.  It also goes up in infections, inflammatory conditions, cancer, and in normal people elevations have been noted for no apparent reason.  So I suggest you not worry about it.  If it is due to something serious, that something will show up sooner or later, but given that you've had the elevation for a while, it's probably not cancer.  Hope this helps.  

Oncology (General Cancer)

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Donald Higby, M.D.

Expertise

I can answer almost all questions related to the treatment and natural course of most kinds of cancer, especially cancers of prostate, colon, lung and breast.

Experience

I have been a practicing medical oncologist for 36 years, and have been chief of service at a major medical center for 25 years. I've also done research in cancer treatments.

Organizations
American Society of Clinical Oncology

Publications
New England Journal of Medicine American Journal of Medicine Journal of the American Society of Clinical Oncology Hematology Transfusion Medicine

Education/Credentials
MD, Stanford University Internal Medicine residency, St. Louis University School of Medicine, St. Louis, MO Medical Oncology Fellowship, Roswell Park Cancer Institute, Buffalo, NY

Awards and Honors
America's Best Physicians, last 14 years

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